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Declaration of Domicile and Citi%en~hipUCl[.cOfJNn, ru.
TO THE STATE AND COUNTY TAX ASSESSOR,
St. Luc ie
COUNTY, FLORIDA:
This is my declara.tion of Domicile and Citizel18bip in the State of Flor!da that I am filing this day in
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accordance, and in conformity with Chapter 222, Se<.:tion 222.17, Florida Statutes.
I wag foralerly a legal resident of "..
Houdon
Tennessee
,. County"... .,__:::-- '...'...__, ___ ,_...""Jhlntmnlqm,---
(City) (St&t.tl~
, However, I have changed my domicile
and I resided at R t 1
- ~. .-
(Street and Numbet)
to and am ami hu\'e been a bona fide resident of the State of Florida since
leth
day of
!-::lrch
, 19, 6~, and I reside at "j\ieCl,d,Q,''lbrOQJ~,I).9i,ryF,arpl.J. G;L,~,~~.~ Cut-
(Su-eet and Number) off
,..'~ '_ ,.....", .... County, Florida,
._. _. _, __w___... ._" ___
St. Lucie
Fort pierce
(City)
ilnrl thiR !\tatement is to be taken as my declaration oI citizenship, actual
the StHh' of Florida,
legal residence and do~icile in
(Insert here any ~'~rtinent h.ct..s. auch as sale of properly or buaineas. or relinQuiahment of emplc.>)'mllDl at
former domicile, removal of family to n;!w domicilt, purcha.. of home, ~ .
~ntt;l~ing
Charles Richard Lowe in the first rrade
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I FURTHER CERTIFY that I will regist~r at my local address when the registration books i'evpen,
and comply with all oth(>r requirements of a legal resident of this State.
I :I<'URTHER CERTIFY that I have no intention to return to my former domicile, and I intend to remain
in.
Fort Pi (,l~ce
(City)
--------,
,______,~,~,.,~ll,c.~,~.....,_____COunty. Florida, ,
permanently.
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)lll~AI, /.),"jut~'.y,/)__f~k,~,:", _m,,'''__''''
(Name)
Mrs.Charles Lowe (Anna)
21
Sworn to and subscribed before me this ... day of
~ ~~~~ri~.t;' 19~~l.
Jan 15, 1964
(AddNII )
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My Commission expires...
(To be ex!Cuted in -iupliC'ate and oriJinal flied with Clerk Circuit Court, and du!,Jlcate with Tax Auessor)
"o..n 81lDDlv ('0., Plant City. .'1".